Joint Replacement Surgery Linked With Increased Risk of Heart Attack

Older adults who have total hip replacement (THR) or total knee replacement (TKR) surgery are at an increased risk of heart attack, say authors of a study that included records of more than 95,000 Danish patients who underwent a primary THR or TKR from January 1, 1998, through December 31, 2007.

During the first 2 postoperative weeks, the risk of heart attack was substantially increased in THR patients compared with controls (adjusted hazard ratio [HR] 25.5). The risk remained elevated for 2 to 6 weeks after surgery (adjusted HR, 5.05) and then decreased to baseline levels. For patients with TKR the risk of heart attack also was increased during the first 2 weeks (adjusted HR, 30.9) but did not differ from controls after the first 2 weeks. The absolute 6-week risk of heart attack was 0.51% in patients with THR and 0.21% in patients with TKR.

The authors say the association was strongest in patients 80 years or older. They could not detect a significantly increased risk in patients younger than 60 years. Additionally, a history of heart attack in the 6 months before surgery increased the risk of new heart attack during the first 6 weeks after THR and TKR surgery, but it did not affect the relationship between THR or TKR and heart attack.

Free, full text of the article is available in Archives of Internal Medicine.